Infection Control @ Wes
Welcome to the homepage for Infection Control @
Wes, a
new campaign spearheaded by the Student Health
Advisory Committee, Davison Health Center and
WesWELL and
funded by the Business Continuity Planning Committee to help reduce the
transmission of infectious diseases at Wesleyan.
The core of our plan is the installation of Purell®
hand sanitizer
dispensers at several key locations on campus. Dispensers were placed outside all computer labs in spring 2007. In the
future we hope to cover other areas such as libraries, dining halls and
Freeman Athletic Center.
A "Clean Your Hands" poster campaign complements the installation of
the dispensers. Click here
to download a copy of the "Clean Your Hands" poster in .pdf format.
If you have questions on Infection Control @ Wes
or on the "Clean Your Hands" campaign that are not answered below,
please email
infectioncontrol@wesleyan.edu.
Frequently Asked Questions
(FAQ)
The following are the most commonly asked
questions about hand-washing and infection control
with answers
(written by SHAC members) drawing from the latest literature in the
field:
Why clean our hands?
The Mayo Clinic states that "infectious diseases
commonly spread through hand-to-hand contact include the common cold,
flu and several gastrointestinal disorders, such as infectious
diarrhea" [1].
Case Study: The effect of hand hygiene on illness rate among
students in university residence halls (Am J Infect Control. 2003
Oct; 31(6):364-70.)
- Background: Several studies have indicated a connection between hand
sanitization and infection control in numerous settings such as extended
care facilities, schools, and hospitals. The purpose of this study
was to assess the effectiveness of both a hand-hygiene message campaign
and the use of an alcohol gel hand sanitizer in decreasing the
incidence of upper-respiratory illness among students living in
university residence halls.
- Method: This study involved a total of 430 students recruited from 4
residence halls during the fall semester at the University of Colorado
at the Boulder campus. Dormitories were paired into control and product
groups. In the product groups, alcohol gel hand-sanitizer dispensers
were installed in every room, bathroom, and dining hall. The data
were statistically analyzed for the differences between product and
control groups in reported symptoms, illness rates, and absenteeism from
classes.
- Results: The overall increase in hand-hygiene behavior and reduction
in symptoms, illness rates, and absenteeism between the product group
and control group was statistically significant. Reductions in upper
respiratory-illness symptoms ranged from 14.8% to 39.9%. Total
improvement in illness rate was 20%. The product group had 43% less
missed school/work days.
- Conclusion: Hand-hygiene practices were improved with increased
frequency of hand washing through increasing awareness of the
importance of hand hygiene, and the use of alcohol gel hand
sanitizer in university dormitories. This resulted in fewer upper
respiratory-illness symptoms, lower illness rates, and lower
absenteeism. [2]
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How effective are Alcohol-Based Hand Sanitizers?
- According to a major review of hand washing practices, alcohol gels
were found to be more effective in the elimination of bacteria and
some viruses than regular hand washing alone [3].
- Another report states that antibiotic soap is "no more effective at
killing germs than are regular soap and water," and also advises that
alcohol-based products "are more effective than soap and water in
killing bacteria and viruses that cause disease" [1].
- Finally, a recent article in Harvard Health Letter finds that
“…in all but a few trials, alcohol-based cleaners have reduced
bacterial counts better than plain soap and several kinds of
antibacterial soap,” although bacterial spores and certain kinds of
viruses might be less susceptible [4].
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When is an alcohol sanitizer not enough?
- There is a major difference between detergents and sanitizers.
Detergents like soap are meant to remove dirt from soiled surfaces.
Soap molecules bind to particles on the hands and remove them from the
skin, but when used alone this has a limited effect on microorganisms.
In contrast, Purell® and other alcohol-based products are very good
germ-killers; they do not remove dirt like soap and water, but are
capable antiseptics.
In general,
when used on visibly clean hands, alcohol sanitizers are highly
effective against the microbes responsible for several human
illnesses. If your hands are soiled, however, hand washing with soap
and water is preferred [1].
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Will the product hurt my skin?
- Ethanol, the active ingredient in Purell®, is very well tolerated by
the skin despite being a mild drying agent. A 2004 survey of hospital
hand washing preferences found that "more than 85% of nurses felt that
[an] alcohol hand rub caused less skin dryness than did washing with
soap and water" [3]. This finding has been upheld in more recent
research [5, 6].
- Wesleyan's
stations dispense Purell® with a moisturizing emollient, which reduces
the drying effect of the ethanol. Alcohol-based formulations sold in
drug stores generally include aloe, but lack the additional
moisturizers included in our sanitizer.
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Can using sanitizers
compromise my immune system?
- Hand sanitization with an alcohol-based rub kills microorganisms
indiscriminately, but the effect on the normal hand flora is
transient and insignificant [3]. Resident, potentially beneficial
bacteria will repopulate the hands rapidly after the product has
been used, while harmful bacteria and viruses will take longer to be
reintroduced.
- Using hand sanitizer will not completely
eliminate your exposure to infectious pathogens, and provides no
lasting protection after the product has evaporated. Thus, while our
immune systems might benefit from occasional exposure to infections,
use of these products should not interfere with that normal amount of
background contact.
- Hand sanitizer
is best used before eating and after contact with likely-contaminated
surfaces, when killing microbes is known to prevent unnecessary (and
potentially serious) illnesses [1].
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Can alcohol-based products lead to antimicrobial
resistance?
- According to the Centers for Disease Control: "Antibiotic resistance occurs when bacteria
change in a way that reduces or eliminates the effectiveness of
antibiotics. These resistant bacteria survive and multiply - causing
more harm, such as a longer illness, more doctor visits, and a need
for more expensive and toxic antibiotics" [7].
- Resistance occurs when certain types of products are used
excessively, and is more commonly associated with the
over-prescription of antibiotics than hand cleaning. Ethanol, the
active ingredient in Purell®, kills cells quickly and then
evaporates. Since bacteria generally require prolonged exposure to
an agent in order adapt and become resistant, the rapid killing
effect and evaporation of ethanol means there is less chance for
resistance to occur. Furthermore, even if microorganisms could
become more tolerant of alcohols, this would not affect their
susceptibility to antibiotics like penicillin.
- A
recent review article explored whether alcohol-based sanitizers can
elicit the kind of resistance seen to develop against antibiotics;
this study found no documented resistance associated with
alcohol-based hand sanitizers, and the authors report that the potential for such resistance remains widely doubted [3].
Alcohols have been used as disinfectants for decades without any
evidence of resistant or tolerant strains.
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What else can be done to limit disease
transmission?
- Always remember to properly cover your
cough, and remind others to do the same! It is best to cough
or sneeze directly into the upper arm, as this prevents airborne
particles from being released into the air. Instead of spreading to
others, potentially infectious microbes will be trapped by clothing
and eventually become inactive.
- Coughing into your hands
increases the likelihood of transmission since all surfaces
touched afterwards will be contaminated. If you do cough or sneeze
into your hands, be sure to wash them immediately.
- View a video entitled "Why Don't We Do It in Our
Sleeves?" below, which demonstrates how to best cover your
cough and sneezes (or
click here if the viewer is not working correctly).
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Feedback
If you have questions on Infection Control @
Wes or on the "Clean Your Hands" campaign that are not answered
on this page, please email
infectioncontrol@wesleyan.edu. Also,
should
you find a paper which contradicts our recommendations, or if you
believe the site contains a factual inaccuracy, please inform us and
we will update this page accordingly.
Sources
1. Mayo Clinic,
Hand washing: A simple way to prevent
infection.
2. White, C., et al., The effect of hand hygiene on
illness rate among students in university residence halls. Am J
Infect Control, 2003. 31(6): p. 364-70.
3. Kampf, G. and A. Kramer, Epidemiologic background of
hand hygiene and evaluation of the most important agents for scrubs
and rubs. Clin Microbiol Rev, 2004. 17(4): p. 863-93,
table of contents.
4. The handiwork of good
health. Harvard Health Letter, 2007. 32(3): p. 1-3
5. Loffler, H., et al. How
irritant is alcohol? Br J Dermatol, 2007. 157(1): p. 1-3.
6. Pedersen, L.K., et al.,
Short-term effects of alcohol-based disinfectant and detergent on skin
irritation. Contact Dermatitis, 2005. 52(2): p. 82-7.
7. Centers
for Disease Control,
Frequently Asked Questions about Antimicrobial Resistance.
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